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Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections

World Journal of Gastroenterology 2016年第11期22卷 3078-3104页

作者： Lynne Vernice Mc Farland Metehan Ozen Ener Cagri Dinleyici shan goh Department of Medicinal Chemistry School of PharmacyUniversity of Washington Faculty of Medicine Department of PediatricsDivision of Pediatric Infectious Diseaseatakent acibadem University Hospital Faculty of Medicine Department of PediatricsPediatric Intensive Care UnitEskisehir Osmangazi University Department of Pathology and Pathogen Biology Royal Veterinary College

Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.

关键词： Antibiotics Antibiotic-associated diarrhea Clostridum difficile infections Adults Pediatrics Diarrhea Risk factors Treatments Prevention

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Preventing pediatric antibiotic-associated diarrhea and Clostridium difficile infections with probiotics: A metaanalysis

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World Journal of Meta-Analysis 2013年第3期1卷 102-120页

作者： Lynne V Mc Farland shan goh Department of Medicinal Chemistry University of Washington Seattle WA 98101 United States Department of Pathology and Pathogen Biology Royal Veterinary College Hawkshead Lane Hatfield Hertfordshire AL9 7TA United Kingdom

AIM： To assess the effcacy and safety of probiotics for preventing pediatric：（1） antibiotic associated diarrhea and （2） Clostridium diffcile （C. diffcile） ***： On June 3, 2013, we searched PubMed （1960-2013）, EMBASE （1974-2013）, Cochrane Da-tabase of Systematic Reviews （1990-2013）, CINAHL （1981-2013）, AMED （1985-2013）, and ISI Web of Science （2000-2013）. Additionally, we conducted an extensive grey literature search including contact with National Institutes of Health Clinical Trials Registry, abstracts from annual infectious disease and gastroen-terology meetings, experts in the feld and correspondence with authors. The primary outcomes were the incidence of antibiotic-associated diarrhea （AAD） and C. difficile infections （CDI）. Dichotomous outcomes （e.g. , incidence of AAD or CDI） were pooled using a random-effects model to calculate the relative risk and corresponding 95% confidence interval （95%CI） and weighted on study quality. To explore possible explanations for heterogeneity, a priori subgroup analysis were conducted on probiotic strain type, daily dose, quality of study and safety of probiotics. The overall quality of the evidence supporting each outcome was assessed using the grading of recommendations, assessment, development and evaluation ***： A total of 1329 studies were identifed with 22 trials （23 treatment arms and 4155 participants） meeting eligibility requirements for our review of prevention of AAD and 5 trials （1211 participants） for the prevention of CDI. Trials in adult populations, trials of uncertain antibiotic exposure or studies which did not provide incidence of AAD were excluded. We found 12 trials testing a single strain of probiotic and 10 trials testing a mixture of probiotic strains. Probiotics （all strains combined） signifcantly reduced the incidence of pediatric AAD （pooled RR = 0.42, 95%CI： 0.33-0.53） and significantly reduced pediatric CDI （pooled RR = 0.35, 95%CI： 0.13-0.92）. Of the two strains wi

关键词： Probiotics Pediatric Antibiotic-associated diarrhea Clostridium diffcile Saccharomyces boulardii Lactobacillus rhamnosus Safety Meta-analysis Randomized clinical trials

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Engineering immunosuppressive drug-resistant armored(IDRA)SARS-CoV-2 T cells for cell therapy

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Cellular & Molecular Immunology 2023年第11期20卷 1300-1312页

作者： Qi Chen Adeline Chia Shou Kit Hang Amy Lim Wee Kun Koh Yanchun Peng Fei Gao Jili Chen Zack Ho Lu-En Wai Kamini Kunasegaran Anthony Tanoto Tan Nina Le Bert Chiew Yee Loh Yun shan goh Laurent Renia Tao Dong Anantharaman Vathsala Antonio Bertoletti Emerging Infectious Disease Program Duke-NUS Medical SchoolSingaporeSingapore National University Centre for Organ Transplantation National University HospitalSingaporeSingapore MRC Human Immunology Unit MRC Weatherall Institute of Molecular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUK Lion TCR Pte Ltd SingaporeSingapore A*STAR ID labs Agency for ScienceTechnology and ResearchSingaporeSingapore Lee Kong Chian School of Medicine Nanyang Technological UniversitySingaporeSingapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Singapore Immunology Network A*STARSingaporeSingapore

Solid organ transplant(SOT)recipients receive immunosuppressive drugs(ISDs)and are susceptible to developing severe ***,we analyze the Spike-specific T-cell response after 3 doses of mRNA vaccine in a group of SOT patients(n=136)treated with different *** demonstrate that a combination of a calcineurin inhibitor(CNI),mycophenolate mofetil(MMF),and prednisone(Pred)treatment regimen strongly suppressed the mRNA vaccine-induced Spike-specific cellular *** defects have clinical consequences because the magnitude of vaccine-induced Spike-specific T cells was directly proportional to the ability of SOT patients to rapidly clear SARS-CoV-2 after breakthrough *** then compensate for the T-cell defects induced by immunosuppressive treatment and to develop an alternative therapeutic strategy for SOT patients,we describe production of 6 distinct SARS-CoV-2 epitope-specific ISD-resistant T-cell receptor(TCR)-T cells engineered using the mRNA electroporation method with reactivity minimally affected by mutations occurring in Beta,Delta,Gamma,and Omicron *** strategy with transient expression characteristics marks an improvement in the immunotherapeutic field and provides an attractive and novel therapeutic possibility for immunosuppressed COVID-19 patients.

关键词： T cell therapy Transplantation SARS-CoV-2 Immunosuppressive drug resistant T cells

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“食”成语研究

“食”成语研究

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作者：吴铭珊（goh MIIN shan）苏州大学

学位级别：硕士

本论文以“食”字成语为研究对象,从成语内部的结构、成语的感情色彩、成语的文化色彩两方面,对“食”字成语进行了缜密而细致的研究。从而论证了语言和文化之间密不可分的关系。

关键词：食成语

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结缔组织病相关间质性肺疾病的HRCT定量评估方法对比

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放射学实践 2023年第11期38卷 1399-1408页

作者：郭红红金红阳曹珊杨晨史小琼张皓兰州大学第一临床医学院兰州730000 兰州大学第一医院放射科兰州730000 甘肃省智能影像医学工程研究中心兰州730000

目的:本研究探讨基于高分辨率CT(HRCT)密度阈值法、密度直方图法和综合分析法的不同肺定量评估方法对结缔组织病(CTD)相关间质性肺疾病(ILD)患者严重程度的诊断能力和评估价值。方法:对连续接受HRCT胸部扫描和肺功能检查(PFT)的CTD-ILD... 详细信息

目的:本研究探讨基于高分辨率CT(HRCT)密度阈值法、密度直方图法和综合分析法的不同肺定量评估方法对结缔组织病(CTD)相关间质性肺疾病(ILD)患者严重程度的诊断能力和评估价值。方法:对连续接受HRCT胸部扫描和肺功能检查(PFT)的CTD-ILD患者进行回顾性分析。两位放射科医生使用goh评分在HRCT上对ILD严重程度进行视觉半定量评分,并通过20%的goh评分阈值和70%的用力肺活量(FVC%)阈值对ILD的严重程度进行分组(局限性组/弥漫性组)。记录基于HRCT密度阈值法与密度直方图法的定量指标并通过主成分分析法计算新指标-计算机综合化指数(CII)。采用t检验或Mann-Whitney U检验分析局限性/弥漫性组间各参数差异,使用单因素方差分析(ANOVA)或Kruskal-Wallis H检验比较不同CTD类型之间各参数的差异,使用Spearman相关分析评价各变量间的相关关系,采用受试者操作特征(ROC)曲线分析不同肺定量评估方法区分CTD-ILD严重程度的能力。结果:93例患者纳入研究,其中局限性组42例(45.16%),弥漫性组51例(54.84%)。结果表明,局限性组与弥漫性组间HRCT定量指标、视觉半定量评分及PFT参数差异均具有统计学意义(P<0.05),除MLA-4与DLCO%外,HRCT定量指标、视觉半定量评分及PFT参数之间存在显著相关性。ROC分析显示CII-4和CII-5对CTD-ILD严重程度的区分能力最强,AUC分别为0.886(95%CI:0.813~0.959)、0.883(95%CI:0.807~0.958)。结论:HRCT密度阈值法、密度直方图法和综合分析法等定量方法为评估CTD-ILD患者肺功能损害严重程度提供了客观指标,对区分预后较差的弥漫性CTD-ILD患者有潜在的重要意义,可作为视觉半定量评分有潜力的替代方法。

关键词：结缔组织病肺疾病,间质性体层摄影术,X线计算机定量评估

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整合素α6单克隆抗体对人乳头瘤病毒6／11病毒颗粒体外感染HaCaT细胞的影响

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中华皮肤科杂志 2011年第5期44卷 326-329页

作者：柯吴坚车雅敏陈敬刘原君刘艳芝单士军姚卫锋刘全忠天津医科大学总医院皮肤性病科 300052 天津市公安医院皮肤性病科

目的探讨整合素α6单克隆抗体（goh3）对人乳头瘤病毒（HPV）6／11病毒颗粒（VP）体外感染HaCaT细胞的影响。方法①采用4组不同浓度的HPV6／11VP体外感染HaCaT细胞；②加入6组不同浓度的goh3后，以10^6拷贝／mlHPV6／11vP体外感染HaCaT... 详细信息

目的探讨整合素α6单克隆抗体（goh3）对人乳头瘤病毒（HPV）6／11病毒颗粒（VP）体外感染HaCaT细胞的影响。方法①采用4组不同浓度的HPV6／11VP体外感染HaCaT细胞；②加入6组不同浓度的goh3后，以10^6拷贝／mlHPV6／11vP体外感染HaCaT细胞；③加入稀释倍数为1：100的goh3前后，应用8例临床分离的浓度为10e拷贝／ml的HPV6／11vP体外感染HaCaT细胞；④以上3步分别以荧光定量聚合酶链反应（FQ—PCR）方法检测感染后HaCaT细胞的HPVDNA载量并计算goh3抑制率。结果①4组不同浓度的HPV6／11vP感染细胞后所测得的病毒载量不同（P〈0．01）。当HPV6／11VP浓度为10^6拷贝／ml时，HaCaT细胞被感染率为100％，且所测得的HPV载量高于其他3组（P〈0．05）；②当goh3稀释倍数〉1：100时，其对HPV6／11vP感染HaCaT细胞的抑制率与其浓度成正比；但当稀释倍数〈1：100时，再增加goh3的浓度，其抑制率也未见明显增长；③8例临床分离的HPV6／11VP在加goh3之前感染HaCaT细胞的平均病毒载量为（5．814-2．51）×104拷贝／ml，加入goh3后感染HaCaT细胞的平均病毒载量为（3．02±1．21）×10^4拷贝／ml，计算goh3的平均抑制率为（46．9±4．7）％。结论goh3对HPV6／11 VP黏附到HaCaT细胞具有一定的抑制作用，推测整合素α6可能是HPV6／11VP感染宿主细胞的病毒受体之一。

关键词：人乳头瘤病毒整合素α6 抗体单克隆

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